Drugs available on Contract - [SODIUM BICARBONATE 8.4% INJ (FSB)], []

Contract Number	42
Brand Code	35833
Brand Name	SODIUM BICARBONATE 8.4% INJ (FSB)
Active Ingredient	SODIUM BICARBONATE
Trade Name	SODIUM BICARBONATE
Package Size	10ML
Formulary Category	B
Pkg Price	1.09
Unit Price	1.09
Strength	8.4%
Unit Description	VIAL
Max. Reimbursable Quantity / Month	70
Package Description
Manufacturer Code	FSB
Manufacturer Name	FLAGSHIP BIOTECH
Agent Code	STO
Agent Name	BRYDEN STOKES LTD
Benefit
Benefit Cat Code
Drug Contract Start Date	2026-04-01
Drug Contract End Date	2028-03-31
Restrict To Ophthalmologist	No
Restrict To Pulmonologist	No
SIGCode
SIGFactor	0
Dentist Allowed	N
Therapeutic Code	4008
Therapeutic Desc	ALKALINIZING AGENTS
Status Description
Default Route	IV
Max Repeats	0
Therapeutic Head	ALKALINIZING AGENTS
Amend Date	2026-03-05